22 September 2014

Medical Billing Still Amazingly Abusive

A Sunday New York Time story highlights the fact that health care industry billing practices remain incredibly abusive and bear no meaningful resemblance to the markets seen for other kinds of services.

Somehow, when physicians are involved, it is perfectly O.K. for service providers to bill whatever they want, without entering into a contract agreeing on the price in advance, and without any meaningful connection between the amount charged and the services rendered.

They highlight services rendered by an assistant neurosurgeon in a neck surgery whom the patient never met and had no reason to expect who charged $117,000 for an afternoon's job, when in a Medicaid case, he would have been limited to $800.

It is not so much to ask that health care providers quote a single price in advance and that all bills for a single procedure flow through a single vendor, as it most ordinary markets do. It is also not much to ask that all bills to insured persons be billed to insurance with the insured responsible only to pay his share to his insurer. But, this is almost never how it actually works.